Evidence gap in predicting intracranial haemorrhage risk in people with glioma on anticoagulants: a scoping review

预测接受抗凝治疗的胶质瘤患者颅内出血风险的证据不足:一项范围界定综述

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Abstract

BACKGROUND: People with glioma (PwG), a type of brain tumour, have an elevated risk of developing venous thromboembolism (VTE). When VTE occurs, anticoagulant therapy is typically initiated, and in some cases, it may be prescribed prophylactically. However, these patients are also at risk of intracranial haemorrhage (ICH) as a complication of anticoagulation. Despite the clinical importance of this risk-benefit balance, it remains unclear whether predictive tools exist to guide anticoagulation decisions in this population. METHODS: We conducted a scoping review to determine whether predictive models exist for estimating the risk of intracranial haemorrhage (ICH) in people with glioma (PwG) receiving anticoagulant therapy. For any models identified, we assessed their methodological quality and predictive performance. Our search included MEDLINE, EMBASE (via Ovid), and the Cochrane Library, covering publications up to 29 November 2024. Studies were eligible if they employed predictive modelling to assess ICH risk in anticoagulated PwG. Two reviewers independently screened studies and extracted data. We used the PROBAST tool to evaluate model quality. RESULTS: Of the 1,585 articles screened, none met the inclusion criteria. Although some studies reported on ICH risk in PwG, none developed or validated predictive models tailored to this clinical context. One excluded study provides conceptual insights that may inform future modelling efforts. CONCLUSIONS: The absence of these models underscores a critical gap in neuro-oncology research and highlights the urgent need for targeted model development to support anticoagulation decision-making in PwG.

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